Author reply – Corrected Proof

First, We really appreciate Huisingh and McGwin's interest in our recent publication regarding the study of suppression in patients with anisometropic amblyopia. However, the concerns they raise in their recent correspondence are not directly relevant to our study. The aim of our study was not to measure suppression before and after occlusion therapy. Rather, measurements of suppression, stereopsis, and visual acuity were made in observers with amblyopia (cases) and age-matched observers without amblyopia (controls). For a number of measurements, visual acuity was decreased in the nondominant eye of each control using optical defocus so that it matched the amblyopic eye visual acuity of the case with whom they were paired. In addition, suppression was simulated in controls using neutral density filters. We also examined the relationships between acuity, stereopsis, and suppression in observers with amblyopia and explored the acute effects of spectacle and rigid gas-permeable contact lens correction on suppression in a specified subset of 19 cases (Figure 4 in our original paper). Once the case-control phase of the study was complete, 26 cases had subsequently received occlusion therapy combined with spectacle correction as part of their standard clinical care. Measurements of amblyopic eye visual acuity made at the first follow-up visit after treatment initiation were available for these cases. It has previously been reported that pretreatment measurements of suppression may be related to the outcomes of occlusion therapy, whereby stronger pretherapy suppression is associated with a poorer response to therapy. We therefore investigated whether a similar effect was present in the subset of our cases who had received treatment. We found that cases whose treatment had resulted in an amblyopic eye visual acuity improvement of <0.2 logarithm of the minimum angle of resolution had significantly stronger pretreatment suppression than those whose treatment was considered successful (>0.2 logarithm of the minimum angle of resolution acuity improvement). Detailed descriptions of the experimental design and analyses outlined are provided in our original manuscript.